Denied For Ptsd/anxiety. How To Appeal This Decision?

Denied For Ptsd/anxiety. How To Appeal This Decision?

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Mar 21 13 4:16 PM

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I was hoping I could have some input on my claim decision I just received for my PTSD claim that I initially submitted Dec 2010.

I will type info from my C&P exam, and then decision letter. As I am at a loss for how to proceed with my appeal? and what new evidence I need to present with appeal?? I thought the C&P examiner stated it is least as likely as not that the veteran’s anxiety is related to combat experience.

RATIONALE FOR OPINION GIVEN: Based on clinical interview of the veteran and review of available records, it is the opinion of this examiner that he does not currently meet the criteria for PTSD; a more appropriate qualification of his current anxiety symptom’s is a diagnosis of Anxiety Disorder, Not Otherwise Specified. There is no evidence of any pre- or post service trauma that would better explain the veteran's current anxiety symptom presentation; therefore, it is least as likely as not that the veteran’s Anxiety Disorder is related to his conceded military combat experience.

We did not find a link between Anxiety disorder not otherwise specified (claimed as post-traumatic stress disorder (PTSD) and military service.

Explanation: We received your medical evidence from VA examination and VA outpatient treatment records, which discusses the symptom’s of your medical condition. Your service treatment records do not contain complaints, treatments, or diagnosis for this condition.On July 13, 2010, the regulation regarding the evidence required to support an in-service stressor for PTSD was amended. According to the amendment, service connection for PTSD may be granted if the evidence demonstrates a current diagnosis of PTSD (rendered by an examiner specified by the regulation); an in-service stressor consistent with the places, types, and circumstances of service (satisfactorily established by lay testimony) has been medically related to the Veteran's fear of hostile military or terrorist activity by the VA psychiatrist or psychologist, or one contracted with the VA; and the Veteran’s PTSD symptoms have been medically related to the in-service stressor by a VA psychiatrist or psychologist, or one contracted with by VA. Your VA examiner determined that you do not meet the requirements for a diagnosis of PTSD. Instead, you were diagnosed with anxiety disorder otherwise specified. As a result, the relaxed standards (described above) for establishing an in-service stressor cannot be applied in your case, because the relaxed standards only apply to Veterans with clinical diagnosis of PTSD. We are unable to verify the in-service stressors you reported in support of your claim. Due to the fact that your records fail to show an event, disease, or injury in service related to your mental condition, a direct link between your current condition and your military service cannot be made.

I do not know what to do? Do I appeal asking to be evaluated for PTSD, and Anxiety secondary? All my diagnoses from VA mental health is for Anxiety and related to experiences from deployment.

Thanks for any help, advice, or suggestions on the course of action I should take next. I know I need to file a NOD ..but, what evidence do I now need to provide the VA??

First off, you can submit either a NOD/Notice of disagreement or ask for a DeNovo review. I'd opt for the Denovo, if this is your first denial on your claim. With your letter disagreeing, submit a letter from yourself, stating factually what tragic event or trauma you were a witness to or involved in. Keep it simple, unemotional and as non tech as possible.

Get supporting letters from your buddies, former soldiers, family who know first hand, like you were writing to them from a war zone, events of a daily patrol, got ambushed, were under fire, you watched your combat buddy being killed.....things of that nature.

As AKC pointed out its pretty cut and dried. The narritave indicates a willingness to approve PTSD but with a GAD diagnosis and no inservice reference this claim is DOA. A NOD is not in order as well, unless you can have you MH provider clarify that the GAD was in fact PTSD and had been misdiagnosed there will be no chance to be succesful in holding the earlier file date.

You REALLY need to get your treating physician to diagnose PTSD. Without that diagnosis, you have no claim for PTSD.

You might get them to explain, in some detail, how your current GAD is related to your combat experiences. And, why they diagnose GAD, rather than PTSD.

Now for you. If you are holding feeling, symptoms, etc, back, and not sharing them with your therapist (this is VERY common with PTSD), it is time to get them all out on the table. You NEED to have everything out there, warts and all, so you can:

Hi oefracer35, I am seeing a trend here on this site as more of us are getting the anxiety nos from the c and p s. I had mine in Feb for Ptsd and got anx nos as well. i do have a diagnosis of ptsd from my private doc. its gotten worse recently so I put my claim in 2011. My doc was not impressed with the hack job of the c and p and will write a rebuttle letter.

Talk to a vso or someone who will help or respresent you. You have some choices on the appeal with back pay or a new claim....you can get the medical help now anyway as you are with va so its about the compensation talk to someone....get some independent advice from few sources. No one said this was going to be an easy or fair fight.....

The Old Medic wrote:You REALLY need to get your treating physician to diagnose PTSD. Without that diagnosis, you have no claim for PTSD.

You might get them to explain, in some detail, how your current GAD is related to your combat experiences. And, why they diagnose GAD, rather than PTSD.

Now for you. If you are holding feeling, symptoms, etc, back, and not sharing them with your therapist (this is VERY common with PTSD), it is time to get them all out on the table. You NEED to have everything out there, warts and all, so you can:

1. Get the appropriate diagnosis, and the appropriate treatment

2. Get an approved claim for mental problems.

Old MedicHe also needs to have a therapist he can have appropriate rapport with or it's very doubtful that he will actually open up in order for a correct diagnosis to be made. Many naturally hold back and are very reluctant to tell all or share all.

In this mans case, if he is doing that, he is hurting himself badly. He wants service connection (and likely deserves to have it), but there is no actual evidence supporting his claim (no Nexus has been established), and NO DIAGNOSIS OF PTSD. He has to establish that something happened while on active duty to cause the anxiety and/or PTSD (which IS an Anxiety Disorder by definition). In order to do that, he is going to have to open up, at least to some degree, in order to get that all important diagnosis.